Effectiveness of Pharmacist-Led Provider Education on Antimicrobial Discharge Prescriptions for Common Infections.

Background

Several strategies described in the literature regarding the role of pharmacist-led educational interventions to healthcare providers, however, evidence available on the role of education in the Emergency Department (ED) setting on discharge prescriptions is limited. The purpose of this study was to evaluate the impact of pharmacist-led education on antimicrobial prescribing at discharge from the ED.

Objective

To determine whether pharmacist-led provider education improves patient outcomes by reducing medication-related errors in the ED when prescribing antimicrobials at discharge for skin and soft tissue infections (SSTIs), urinary tract infections (UTIs), and community-acquired pneumonia (CAP).

Methods

This was a retrospective pre-vs post-intervention cohort study at Maimonides Medical Center (MMC). A total of 192 patients in the pre-intervention period and 181 patients in the post-intervention period were included. The primary endpoint was appropriateness of antimicrobial discharge prescriptions pre- and post-intervention.

Results

In the pre-intervention period, 17.7% of patients had an SSTI, 47.4% had a UTI, and 34.9% had CAP. In the post-intervention period, 15.5% of patients had an SSTI, 51.4% had a UTI, and 33.1% had CAP. After implementation of pharmacist-led provider education, there was a statistically significant increase in the number of appropriate antimicrobial discharge prescriptions in the post-intervention period, 86.7% vs 75.5% respectively (P = .008). While there was no statistically significant difference in recurrent infections, there was a trend towards improvement in post-intervention period, 3.9% vs 5.7% respectively (P = .473).

Conclusion

Pharmacist-led provider education significantly improved prescribing patterns for antimicrobial discharge prescriptions.